The Biden administration has announced that they are “recommending” a momentary pause in usage of the Johnson & Johnson one-shot COVID-19 vaccine after six U.S. patients out of 6.8 million administered doses developed a rare but “severe type of blood clot” in the weeks after vaccination. The pause is expected to last only days, but already Americans are reporting Johnson & Johnson vaccination appointments for today being cancelled. While the White House asserts that the increased supply of other vaccines means there will be little overall effect on vaccination rates, there’s no question the cancellation of appointments will disrupt many Americans’ own efforts to get vaccinated, and the news is likely to further convince some vaccine skeptics to avoid getting any of the available shots.
That’s the top line news, and what Americans woke up to this morning. The details are considerably less alarmist and the administration is already facing significant criticism for the brief delay. There is, at the moment, no evidence of causality between the vaccine and clotting, meaning experts do not yet know whether the six cases are entirely coincidental. Each case coincided with getting the Johnson & Johnson vaccination six to 13 days earlier, but the incredible rarity of the condition—literally, one case per 1+ million vaccine doses—will make it difficult to tease out a connection.
The primary reason for the pause appears to be so that medical providers can be hastily briefed on the extremely rare condition and how to properly administer treatment. The drug typically used to reverse blood clotting is heparin, an anticoagulant. For this particular type of clotting, which is called thrombocytopenia, administering heparin can be extremely dangerous. Alternative treatments are required, and federal experts intend to use the momentary pause to push out nationwide instructions on how to identify and treat patients who might develop the condition.
To once again emphasize the point: It is not established that the vaccine caused any of these ultra-rare clots to begin with. Experts don’t know yet, so even if you’re the sort of person inclined to panic about these things: don’t. It can be frustrating to watch medical science grapple with these questions in public, and it’s not made better after a year of uncontrolled pandemic has frayed every nerve in the country. But you have a considerably greater chance of getting into a fatal car accident on your way to your Johnson & Johnson vaccine appointment than you do of coming down with this ultra-rare type of blood clot, even if the two do turn out to be related. Get the vaccine. Get whichever you can get, unless your own doctor tells you you shouldn’t.
The (rather astounding) federal caution on display here is almost assuredly due to months of concerns over the AstraZeneca vaccine, a medically similar vaccine alleged to rarely—possibly—cause the same type of clotting. Those reports continue to be probed, and it still may turn out that both the AstraZeneca and now Johnson & Johnson vaccines are being linked to these cases in error.
Non-vaccine related thrombocytopenia is estimated to affect roughly 33 of each 1 million U.S. adults per year, which would appear to put six reports of clotting in the two weeks after a Johnson & Johnson vaccination at something very close to the “normal” background rate of such reports. Even if it does turn out that the immune response generated by this particular vaccine has a one-per-million chance of causing such clotting, those risks remain much, much lower than the risk of death from COVID-19 itself—and COVID-19 can itself cause widespread organ damage even when it doesn’t kill you outright.